The Poor Use of Methadone in Italian Hospices.
The poor use of methadone in Italian hospices.
Support Care Cancer. 2013 Mar 16;
Mercadante S, Valle A, Agnelotti C, Caruselli A
PURPOSE: A hospice may provide an ideal setting to use methadone because of a more protective environment in comparison with a home care setting, where it is seldom used. The aim of this survey was to investigate the frequency of the use of methadone in Italian hospices and how it is used. METHODS: The Italian registry of palliative care institutions, named Osservatorio Federazione cure palliative, was consulted at its official website. Phone interviews were planned with physicians who were delegated to provide the answers. Data regarding the hospice and experience of physicians were collected. Questions regarding the attitudes in using methadone were posed, including the frequency of use and how this drug was used. RESULTS: Of 165 centers contacted, information was available for 138 hospices (83.6 %). The majority of interviewed physicians considered methadone as a difficult drug to use, and only 38 responders (27.5 %) were using methadone as an analgesic in a minority of patients (less than 5 % in more than half of responders). When methadone is used as first opioid, all the patients receive less than 10 mg/day. Almost all physicians switched from morphine to methadone and used a conversion ratio inversely proportional to the morphine dose. CONCLUSIONS: Physicians working in hospices should improve the knowledge regarding the use of opioids, including methadone, as well as complex treatments which can be the principal reason for hospice admission.
HubMed – Methadone
Predictors of retention in community-based methadone maintenance treatment program in Pearl River Delta, China.
Harm Reduct J. 2013; 10: 3
Yang F, Lin P, Li Y, He Q, Long Q, Fu X, Luo Y
The aims were to identify predictors of treatment retention in methadone maintenance treatment (MMT) clinics in Pearl River Delta, China.Retrospective longitudinal study. Participants: 6 MMT clinics in rural and urban area were selected. Statistical analysis: Stratified random sampling was employed, and the data were analyzed using Kaplan-Meier survival curves and life table method. Protective or risk factors were explored using Cox’s proportional hazards model. Independent variables were enrolled in univariate analysis and among which significant variables were analyzed by multivariate analysis.A total of 2728 patients were enrolled. The median of the retention duration was 13.63 months, and the cumulative retention rates at 1,2,3 years were 53.0%, 35.0%, 20.0%, respectively. Multivariate Cox analysis showed: age, relationship with family, live on support from family or friends, income, considering treatment cost suitable, considering treatment open time suitable, addiction severity (daily expense for drug), communication with former drug taking peer, living in rural area, daily treatment dosage, sharing needles, re-admission and history of being arrested were predictors for MMT retention.MMT retention rate in Guangdong was low and treatment skills and quality should be improved. Meanwhile, participation of family and society should be encouraged.
HubMed – Methadone
Methadone – Vivo 10.09.09 – Una Casa PT I – Vivo 10.09.09 – Una Casa Club.
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